Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in patients with obstructive sleep apnea: a prospective clinical study

Zhengfei Huang; Pien F N Bosschieter; Ghizlane Aarab; Maurits K A van Selms; Joost W Vanhommerig; Antonius A J Hilgevoord; Frank Lobbezoo; Nico de Vries

doi:10.5664/jcsm.9998

Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in patients with obstructive sleep apnea: a prospective clinical study

J Clin Sleep Med. 2022 Sep 1;18(9):2119-2131. doi: 10.5664/jcsm.9998.

Authors

Zhengfei Huang^{1

2}, Pien F N Bosschieter³, Ghizlane Aarab¹, Maurits K A van Selms¹, Joost W Vanhommerig⁴, Antonius A J Hilgevoord², Frank Lobbezoo¹, Nico de Vries^{1

3

5}

Affiliations

¹ Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
² Department of Clinical Neurophysiology, OLVG, Amsterdam, The Netherlands.
³ Department of Otorhinolaryngology-Head and Neck Surgery, OLVG, Amsterdam, The Netherlands.
⁴ Department of Research and Epidemiology, OLVG Hospital, Amsterdam, The Netherlands.
⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.

Abstract

Study objectives: The primary aim was to predict upper airway collapse sites found in drug-induced sleep endoscopy (DISE) from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in patients with obstructive sleep apnea (OSA). The secondary aim was to identify the above-mentioned parameters that are associated with complete concentric collapse of the soft palate.

Methods: All patients with OSA who underwent DISE and simultaneous snoring sound recording were enrolled in this study. Demographic, anthropometric, clinical examination (viz., modified Mallampati classification and Friedman tonsil classification), and sleep study parameters were extracted from the polysomnography and DISE reports. Snoring sound parameters during DISE were calculated.

Results: One hundred and nineteen patients with OSA (79.8% men; age = 48.1 ± 12.4 years) were included. Increased body mass index was found to be associated with higher probability of oropharyngeal collapse (P < .01; odds ratio = 1.29). Patients with a high Friedman tonsil score were less likely to have tongue base collapse (P < .01; odd ratio = 0.12) and epiglottic collapse (P = .01; odds ratio = 0.20) than those with a low score. A longer duration of snoring events (P = .05; odds ratio = 2.99) was associated with a higher probability of complete concentric collapse of the soft palate.

Conclusions: Within the current patient profile and approach, given that only a limited number of predictors were identified, it does not seem feasible to predict upper airway collapse sites found in DISE from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in patients with OSA.

Citation: Huang Z, Bosschieter PFN, Aarab G, et al. Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in obstructive sleep apnea patients: a prospective clinical study. J Clin Sleep Med. 2022;18(9):2119-2131.

Keywords: acoustic analysis; clinical data; drug-induced sleep endoscopy; obstructive sleep apnea; snoring sound; upper airway.

MeSH terms

Adult
Airway Obstruction* / complications
Endoscopy
Female
Humans
Male
Middle Aged
Prospective Studies
Sleep
Sleep Apnea, Obstructive* / complications
Snoring / complications
Snoring / diagnosis